Visitors sang “Happy Birthday” in Dutch, as his English is fading. Cake was allowed, but it had to be served with plastic cutlery and without candles.

Van Zuiden has dementia. In October 2016, Calgary police charged him with second-degree murder in the death of his wife of nearly six decades, Audrey. Loved ones have described them as soulmates.

They say he doesn’t understand why he’s at the Southern Alberta Forensic Psychiatry Centre, which he sometimes mistakes for a homeless shelter or a fancy resort.

He occasionally asks if he has ever been married. Valerie Walker, a longtime friend who grew up with Audrey in the United Kingdom, tells him he did have a spouse, but she died. When he asks how, Walker simply tells him his wife’s heart gave out.

He’ll ask again five minutes later.

“Nothing stays with him for very long.”

Van Zuiden was found unfit to stand trial earlier this year. It’s left him in a state of limbo as the charge remains outstanding.

Alberta Justice says the Crown hasn’t ruled out a stay of proceedings, but won’t do that without a plan to ensure public safety and van Zuiden’s well-being.

“This is such a unique case and it tests both the health system and the justice system significantly,” said Walker’s son, Vince, the van Zuidens’ godson.

It also highlights some of the challenges courts face as Canada’s population ages. Statistics Canada conservatively projects almost one-quarter of Canadians will be over 65 by 2030 compared with 15 per cent in 2013.

“Our entire criminal justice system needs to come to grips with the fact that everybody is getting older,” said Laura Tamblyn Watts, staff lawyer and senior fellow at the Canadian Centre for Elder Law.

“What works for somebody who may be 25 years old just doesn’t work for somebody who’s 85 years old.”

The challenge is broader than just dementia.

“It’s hard to have a right to a fair trial if older people can’t hear the proceedings, can’t see the evidence, are having a hard time remembering the issues against them or are having a hard time accessing services,” she said.

When people are found unfit to stand trial, the assumption normally is that with treatment they will eventually be well enough to face the accusations in court, said Patrick Baillie, a lawyer and forensic psychologist.

“And yet dementia is not going to get better. There is not going to be some time in the future when this individual is able to now understand at a level sufficient to be able to participate in the process,” he said.

“And then you end up with the health-care system saying, ‘Well, but is he some level of risk?’”

The van Zuidens met in Calgary and ran a sailboat business together. They had no children.

Van Zuiden chronicled his experience as a Jewish boy in Nazi-occupied Holland in his book “Call Me Mom: A Dutch Boy’s WWII Survival Story.” As his family separated and went into hiding, he was shuttled between strangers’ homes and lived in a chicken coop for a time.

Van Zuiden dialled 911 himself in the early morning of Oct. 4, 2016.

A detective broke the news to Walker that her friend was dead.

“All he said was ‘blunt instrument.’ He said, ‘You don’t want to go and see her. I wouldn’t advise it.’”

Walker said it’s possible van Zuiden thought he was under attack.

“When the police talked to him he thought they were Nazis, so he might well have gone back into his previous life.”

She said the officers handled the situation well.

“They treated him kindly and with respect.”

Walker and her son were part of a large contingent that came to court for each of van Zuiden’s appearances.

“Certainly seeing him in court that first time, it was heartbreaking,” said Vince Walker. “So lost.”

People at the hospital where van Zuiden is being housed tend to stay short term for court-ordered psychiatric assessments or long term if they have been found not criminally responsible for an offence.

The first visits to the psychiatry centre were tough.

At first, visitors were only able to interact with van Zuiden through a pane of glass and speaking through a phone. Now at least they can sit together in the dining room. Vince Walker said he wishes he could see his godfather play chess or basketball instead of hearing about it second-hand from staff.

Van Zuiden has been cleared by the Alberta Review Board to be moved to a secure seniors home in Calgary, but there were about a dozen people ahead of him on the waiting list in late November.

Loved ones want the charge to be stayed so that he isn’t remembered as an accused murderer. But if that were to happen, he would no longer be the province’s responsibility and they would be left on their own. Staying at the psychiatry centre may be the best option for him.